Language：Japanese   Publisher：(一社)日本神経学会  

Ichushi

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE:  To synthesize available evidence from case reports regarding the efficacy of knee-ankle-foot orthosis (KAFO) on functional mobility and activities of daily living (ADL) in patients with stroke. METHODS:  The following databases were searched, based on the Population Intervention Comparison Outcome (PICO) model: PubMed, CINAHL, Sco- pus, Cochrane Central Register of Controlled Trials, PEDro, Web of Science, and Igaku Chuo Zassi (in Japanese). Methodological quality was assessed using the CARE checklist. RESULTS:  A total of 14 articles, including 15 cases, were selected. Clinically meaningful improvement in functional mobility was reported in 10 of 15 cases, measured using the Functional Ambulatory Category, Trunk Control Test, walking speed, and Berg Balance Scale. Clinically meaningful improvement in ADL was reported in 9 of 15 cases, measured using the Barthel Index and Functional Independent Measure. However, the methodological quality of the reviewed articles was low, with missing information on limitations of management, adverse events, and patient-reported outcomes. CONCLUSION:  This systematic review of case reports found a low level of evidence of the efficacy of KAFO in terms of improvement in functional mobility and ADL. Of value, this study revealed the optimal outcomes for measuring the efficacy of KAFO.

DOI： 10.2340/jrm.v54.87

PubMed

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

OBJECTIVE: The aim of this study was to examine the feasibility and informativeness of the Canadian Occupational Performance Measure (COPM) for identifying the priorities of patients with Parkinson's disease (PD). METHODS: The COPM was administered in patients with PD who were admitted to the hospital. Feasibility was investigated by confirming the acceptability and practicality of the COPM interview. To investigate informativeness, identified priorities were classified according to the International Classification of Functioning, Disability and Health (ICF) and were cross-referenced with data from similar studies using the Patient-Specific Functional Scale (PSFS) and the Patient-Specific Index for PD (PSI-PD). RESULTS: All 61 patients who participated in this study completed the COPM, and a total of 197 priorities were identified. The most frequently identified priorities were "Recreation and leisure," "Preparing meals," "Walking," "Doing housework," and "Caring for household objects." The priorities identified using the PSFS and the PSI-PD were less diverse and focused on "Mobility" or "Self-care." CONCLUSIONS: The COPM is a feasible and informative tool for identifying priorities in patients with PD. Its informativeness was demonstrated by its ability to identify diverse priorities across the ICF domains of "Activity and participation" that had not been identified in the studies using the PSFS and PSI-PD.

DOI： 10.1080/09593985.2021.2023926

PubMed

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Language：English   Publishing type：Research paper (scientific journal)  

Although mindfulness-based stress reduction (MBSR) improves cognitive function, the mechanism is not clear. In this study, people aged 65 years and older were recruited from elderly communities in Chitose City, Japan, and assigned to a non-MBSR group or a MBSR group. Before and after the intervention, the Japanese version of the Montreal Cognitive Assessment (MoCA-J) was administered, and blood samples were collected. Then, neuron-derived extracellular vesicles (NDEVs) were isolated from blood samples, and microRNAs, as well as the target mRNAs, were evaluated in NDEVs. A linear mixed model analysis showed significant effects of the MBSR x time interaction on the MoCA-J scores, the expression of miRNA(miR)-29c, DNA methyltransferase 3 alpha (DNMT3A), and DNMT3B in NDEVs. These results indicate that MBSR can improve cognitive function by increasing the expression of miR-29c and decreasing the expression of DNMT3A, as well as DNMT3B, in neurons. It was also found that intracerebroventricular injection of miR-29c mimic into 5xFAD mice prevented cognitive decline, as well as neuronal loss in the subiculum area, by down-regulating Dnmt3a  and Dnmt3b  in the hippocampus. The present study suggests that MBSR can prevent neuronal loss and cognitive impairment by increasing the neuronal expression of miR-29c.

DOI： 10.1038/s41598-021-01318-y

PubMed

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：Research paper (other academic)   Publisher：(株)北隆館  

Ichushi

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Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.bbih.2020.100149

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Language：English   Publishing type：Research paper (scientific journal)  

Alzheimer's disease (AD) is characterized by the accumulation of amyloid-β and tau. We previously reported that administration of bone marrow mesenchymal stem cells (BM-MSCs) ameliorates diabetes-induced cognitive impairment by transferring exosomes derived from these cells into astrocytes. Here, we show that intracerebroventricularly injected BM-MSCs improve cognitive impairment in AD model mice by ameliorating astrocytic inflammation as well as synaptogenesis. Although AD model mice showed an increase in NF-κB in the hippocampus, BM-MSC-treated AD model mice did not show this increase but showed an increase in levels of microRNA (miR)-146a in the hippocampus. Intracerebroventricularly injected BM-MSCs were attached to the choroid plexus in the lateral ventricle, and thus, BM-MSCs may secrete exosomes into the cerebrospinal fluid. In vitro experiments showed that exosomal miR-146a secreted from BM-MSCs was taken up into astrocytes, and an increased level of miR-146a and a decreased level of NF-κB were observed in astrocytes. Astrocytes are key cells for the formation of synapses, and thus, restoration of astrocytic function may have led to synaptogenesis and correction of cognitive impairment. The present study indicates that exosomal transfer of miR-146a is involved in the correction of cognitive impairment in AD model mice.

DOI： 10.1038/s41598-020-67460-1

PubMed

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Publishing type：Research paper (scientific journal)  

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Authorship：Lead author   Publishing type：Doctoral thesis  

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Authorship：Lead author   Language：English   Publishing type：Research paper (scientific journal)  

Although the cognitive impairment in Alzheimer's disease (AD) is believed to be caused by amyloid-β (Aβ) plaques and neurofibrillary tangles (NFTs), several postmortem studies have reported cognitive normal subjects with AD brain pathology. As the mechanism underlying these discrepancies has not been clarified, we focused the neuroprotective role of astrocytes. After examining 47 donated brains, we classified brains into 3 groups, no AD pathology with no dementia (N-N), AD pathology with no dementia (AD-N), and AD pathology with dementia (AD-D), which represented 41%, 21%, and 38% of brains, respectively. No differences were found in the accumulation of Aβ plaques or NFTs in the entorhinal cortex (EC) between AD-N and AD-D. Number of neurons and synaptic density were increased in AD-N compared to those in AD-D. The astrocytes in AD-N possessed longer or thicker processes, while those in AD-D possessed shorter or thinner processes in layer I/II of the EC. Astrocytes in all layers of the EC in AD-N showed enhanced GLT-1 expression in comparison to those in AD-D. Therefore these activated forms of astrocytes with increased GLT-1 expression may exert beneficial roles in preserving cognitive function, even in the presence of Aβ and NFTs.

DOI： 10.1038/s41598-018-19442-7

PubMed

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Language：English  

Increasing evidence suggests that an enriched environment (EE) ameliorates cognitive impairment by promoting repair of brain damage. However, the mechanisms by which this occurs have not been determined. To address this issue, we investigated whether an EE enhanced the capability of endogenous bone marrow-derived mesenchymal stem/stromal cells (BM-MSCs) to prevent hippocampal damage due to diabetes by focusing on miRNA carried in BM-MSC-derived exosomes. In diabetic streptozotocin (STZ) rats housed in an EE (STZ/EE), cognitive impairment was significantly reduced, and both neuronal and astroglial damage in the hippocampus was alleviated compared with STZ rats housed in conventional cages (STZ/CC). BM-MSCs isolated from STZ/CC rats had functional and morphological abnormalities that were not detected in STZ/EE BM-MSCs. The miR-146a levels in exosomes in conditioned medium of cultured BM-MSCs and serum from STZ/CC rats were decreased compared with non-diabetic rats, and the level was restored in STZ/EE rats. Thus, the data suggest that increased levels of miR-146a in sera were derived from endogenous BM-MSCs in STZ/EE rats. To examine the possibility that increased miR-146a in serum may exert anti-inflammatory effects on astrocytes in diabetic rats, astrocytes transfected with miR-146a were stimulated with advanced glycation end products (AGEs) to mimic diabetic conditions. The expression of IRAK1, NF-κB, and tumor necrosis factor-α was significantly higher in AGE-stimulated astrocytes, and these factors were decreased in miR-146a-transfected astrocytes. These results suggested that EEs stimulate up-regulation of exosomal miR-146a secretion by endogenous BM-MSCs, which exerts anti-inflammatory effects on damaged astrocytes and prevents diabetes-induced cognitive impairment.

DOI： 10.1371/journal.pone.0204252

PubMed

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Language：Japanese   Publisher：(一社)日本認知症学会  

Ichushi

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Authorship：Lead author,　Corresponding author   Language：English   Publishing type：Research paper (scientific journal)  

The aim of this study was to test the clinical utility of the 6-min walk test (6MWT) for patients with moderate Parkinson's disease (PD) through a determination of factors related to this test. This was a descriptive, observational study carried out at a General Hospital, in-patients. Twenty-four patients with moderate PD were studied. We used Hoehn and Yahr stage ratings (HY stage), Unified Parkinson Disease Rating Scales (UPDRS) motor examination score, 6MWT, Berg Balance scale, Timed 'Up & Go' test (TUG), 10-m walk test (10-m walk speed, 10-m walk steps and cadence), and the energy cost of walking (Ec). The average HY stage was 3.1±0.5 and 6MWT was 340.8±110.9 m. TUG (r=-0.68, P<0.01) and Ec (r=-0.65, P<0.01) were correlated significantly with 6MWT. Multiple regression analysis with age, HY stage, TUG, cadence, and Ec as variables indicated a significant degree of variability in the 6MWT results (R=0.77, P<0.001). The TUG (β=-0.47, P<0.01) and Ec (β=-0.4, P<0.01) were correlated independently with the 6MWT results. In contrast, age, HY stage, and cadence were not independently correlated. The 6MWT is a simple tool for assessing walking capacity for patients with PD. In this study, we confirmed the convergent validity and clinical utility of the 6MWT for patients with moderate PD. The 6MWT is useful for clinical assessment to guide the planning of rehabilitation treatment for patients with moderate PD.

DOI： 10.1097/MRR.0000000000000205

PubMed

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Authorship：Lead author,　Corresponding author   Language：Japanese   Publishing type：Research paper (scientific journal)  

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本認知症学会  

Ichushi

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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Event date： 2017.4

Language：Japanese  

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Event date： 2017.4

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Event date： 2011.4

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Event date： 2011.4

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Event date： 2006.4

Language：Japanese   Presentation type：Oral presentation (general)  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2006&ichushi_jid=J01747&link_issn=&doc_id=20060502470557&doc_link_id=%2Fcb3physi%2F2006%2F0033s2%2F558%2F0279-0279%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb3physi%2F2006%2F0033s2%2F558%2F0279-0279%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Event date： 2004.4

Language：Japanese  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2004&ichushi_jid=J01747&link_issn=&doc_id=20040510130399&doc_link_id=%2Fcb3physi%2F2004%2F0031s2%2F399%2F0200-0200%26dl%3D2&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb3physi%2F2004%2F0031s2%2F399%2F0200-0200%26dl%3D2&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_5.gif

Event date： 2004.4

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Event date： 2003.4

Language：Japanese   Presentation type：Oral presentation (general)  

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2003&ichushi_jid=J01747&link_issn=&doc_id=20030428300835&doc_link_id=%2Fcb3physi%2F2003%2F0030s2%2F835%2F0418-0418%26dl%3D2&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fcb3physi%2F2003%2F0030s2%2F835%2F0418-0418%26dl%3D2&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_5.gif

Presentation type：Symposium, workshop panel (public)  

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Presentation type：Oral presentation (general)  

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Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

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Language：English   Presentation type：Poster presentation  

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Language：Japanese   Presentation type：Oral presentation (general)  

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Presentation type：Oral presentation (general)  

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